Manual Therapy Flashcards
1
Q
Term: Skilled hand movements to mobilize soft tissue and joints for the purpose of pain modulation, increase ROM, decrease soft tissue inflammation
A
Manual therapy
2
Q
Q: What are 3 reasons for using manual therapy?
A
- Pain modulation 2. Increase ROM 3. Decrease soft tissue inflammation
3
Q
Term: Manual therapy techniques comprised of skilled passive movements to joints that are applied at varying speed and amplitudes.
A
Mobilization/manipulation
4
Q
Term: a passive movement technique performed by an operator in a manner that is at all time within the ability of the pt. to prevent the movement
A
Mobilization
5
Q
Term: A passive movement technique performed at the limit of the available passive range at a speed that is beyond the pt.’s control
A
Manipulation
6
Q
Term: High velocity, low amplitude therapeutic movements applied within or at end ROM
A
Thrust manipulation
7
Q
Term: speed
A
Velocity
8
Q
Term: Distance
A
Amplitude
9
Q
Term: force
A
Thrust
10
Q
Content: Two types of mobilization
A
- Passive physiological movement (PPM) or osteokinetmatics
- Passive accessory movement (PAM) or arthrokinematics or joint play
11
Q
Content: limitation to motion - osteokinematics (3)
A
- muscle or soft tissue
- joint capsule
- joint play
12
Q
Content: limitation to motion - arthrokinematics (4)
A
- Ligaments
- Bone congruence
- Intra-articular cartilage
- Joint capsule
13
Q
Q: What is are examples of PPM?
A
Flexion/extension, ABD/ADD, IR/ER
14
Q
Q: What is are examples of PAM?
A
Roll, glide, spin, distraction/compression
15
Q
T/F: Manipulation is within the scope of PT practice.
A
True
16
Q
T/F: PT and Chiropractors are solely responsible for manual therapy.
A
True
17
Q
Q: What is the difference between PT and Chiropractors?
A
- Philosophy is different
- Chiropractor - manipulation can treat and cure any aliment
- PT - use manipulation to decrease pain and increase mobility - Technique is different
- Chiropractor = long levers
- PT = short levers
18
Q
T/F: PTs perform chiropractic manipulations.
A
False
19
Q
Q: Which should you pay more attention to the broad, nationwide practice act or the state specific practice act?
A
State practice acts
20
Q
T/F: Grade 5 manipulation is within KS state practice act
A
True
21
Q
Q: Which 3 states do not allow grade 5 manipulation?
A
- Arkansas
- West Virginia
- Washington
22
Q
T/F: Students do not follow the practice pattern of their CIs and their decisions are not influenced by their CIs practice patterns.
A
False
23
Q
Q: Manual therapy is ____________ for certain people when __________ with certain __________.
A
Beneficial, performed, exercises
24
Q
Content: Possible mechanism for manual therapy (3)
A
- Neuorphysiological
- Mechanical
- Psychological/placebo
25
Content: Neurophysiological mechanism (4)
1. descending pain inhibitory system
2. endogenous opioid release
3. gate control theory
4. change in reflex excitability
26
Content: Mechanical mechanism (3)
1. free up entrapped/torn meniscoid
2. mechanical disruption to intra-articular adhesion
3. stretching of joint capsule
27
Content: Absolute contraindications for manual therapy (8)
1. Malignancy
2. Neurological - cauda equina syndrome
3. Vascular
4. Bone disease
5. Inflammatory conditions
6. Infection
7. Acute symptomatic disc herniation
8. Undiagnosed pain
28
Content: Relative contraindications for manual therapy (12 - general idea)
1. RA
2. Osteoporosis
3. Spondylolisthesis
4. Hypermobility/instability
5. Pregnancy
6. Previous malignant disease
7. Acute trauma
8. Protectice spasm
9. Gross degenerative changes
10. Psychological pain
11. Steroid or anitcoagulant
12. Severe nerve root pain
29
Q: How does the therapists perspective alter the placebo effect?
Communication, use the placebo effect to your advantage
30
Content: Precautions for manual therapy (5)
1. Recent trauma
2. Ligament injury
3. Post-op
4. Empty end feel or muscle spasm
5. acute inflammation
31
Content: Indications for manual therapy (5)
1. mild or moderate pain of musculoskeletal origin
2. joint hypomobility
3. a non-irritable mild/moderate irritable condition
4. remodeling stage of recovery - subacute
5. acute spinal pain without neurological symptoms
32
Content: Kaltenborn distraction grading system (3)
Grade 1 = unloading and decompressing the joint surfaces
Grade 2 = separation of joint surfaces
Grade 3 = joint capsule and ligament stretch
33
Q: _____ seconds of static hold for pain, ______ seconds for stretching joint capsule (Kaltenborn).
10-20, 30-60
34
Diagram: Maitlan grading system - grades of movement for accessory glides
35
Content: Maitland grading system (5)
Grade 1 = small amplitude in the resistance free range (1st 25%)
Grade 2 = large amplitude in the resistance free range (middle 50%)
Grade 3 = large amplitude into resistance or up to resistance (last 50%)
Grade 4 = small amplitude into resistance (last 25%)
Grade 5 = (manipulation) high velocity, small amplitude, thrust movement to the limit of available range or mid range
36
Diagram: Fill in the table below
37
T/F: The grades are based on the normal range.
False, based on restrictions
38
T/F: These grades are progressive.
False: Grade 1 and 4 are similar just performed at different ranges
39
Q: Mobilization: __________ pain, __________ joint play, _____ vigorous, may ______ with it and __________ to manipulation.
Decrease, restore, less, start, progress
40
Q: Manipulation: ___________ pain, _________ joint motion, ________ adhesions, _________ loose bodies, requires ______ \_\_\_\_\_\_, when progress _________ or ___________ do not improve with the use of \_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Decrease, restore, break, remove, more, skills, plateaus, symtpoms, mobilization
41
T/F: Grades 1-4 are assessment and Grade 5 is treatment
True
42
Q: What is the biggest difference between mobilizaiton and manipulation?
Speed, mob = slow, manipulation = fast
43
Content: PAM tests - Assessment of joint glides/accessory motion (3)
1. un-restricted accessory glide
2. excessive accessory glide
3. restricted accessory glide
44
Term: Motion limitaitons due to contractile tissues
Un-restricted accessory glide
45
Term: Ligament or severe degeneration of joint surfaces
Excessive accessory glide
46
Term: Limited joint glide and connective tissues
Restricted accessory glide
47
T/F: If a pt. has CPR, a manipulation is indicated.
False: mobilization would be indicated
48
Content: PAMS tests - Assessment of joint distraction
49
Content: PAM tests - documentation (4)
1. Specify direction of glide
2. Quantity and quality of motion
3. Reproduction of symtpoms/relief of pain
4. Presence of muscle spasms
50
Content: Incorporating mob/man into the assessment (4)
1. Knowledge of joint surface and biomechanics
2. Irritability of symtpoms
3. Type of technique selection
4. What is the focus of treatment - pain vs. resistance
51
Content: Manual technique selection (2)
1. Stages of healing vs. level of irritability
2. Treating pain vs. resistance with mobilization
52
Q: What manual technique would you choose for pain? (3)
1. Least painful technique
2. Low speed, shorter treatment (1-2 bouts of 20-30 sec)
3. Grade 1 and 2
53
Q: What manual technique would you choose for distraction that is for pain?
Grade 1 and 2
54
Q: What manual technique would you use for spinal pain?
Grade 5/manipulation
55
Q: What manual technique would you choose for resistance? (3)
1. More end range techniques - increase vigor as tolerated
2. Quicker speed, longer treatments (3-5 bouts of 45-60 sec)
3. Grade 3 and 4
56
Q: What manual technique would you chosse for distraction for resistance?
Grade 3
57
Content: Manual technique selection - muscle restriction (2)
1. Muscle stretching
2. Hold/relax
58
Content: Manual technique selection - joint restriction (3)
1. Manipulation
2. Grade 3 or 4 mob
3. PPM
59
Content: Manual technique selection - CPR (3)
1. Grade 4 mob
2. Prolonged stretch
3. Distraction with or w/o movement
60
Content: Manual technique selection - extreme hypomobility or pain through ROM
PPM
61
Q: In what position should you perform manual techniques?
Loose packed, with sligh distraction
62
Q: Some approaches advocate preliminary _____ \_\_\_\_\_\_\_\_ therapy or ____________ therapy prior to joint mobilization.
soft, tissue, modality
63
Q: What hip glide facilitates joint mobility and pain relief?
Inferior
64
Q: What hip glide facilitates flexion and IR?
Posterior
65
Q: What hip glide facilitates extension and ER?
Anterior
66
Q: What hip distraction facilitates joint mobility and pain relief?
Lateral
67
Q: What knee PAM facilitates joint mobility and pain relief?
Distraction
68
Q: What knee glide facilitates extension?
Anterior
69
Q: What knee glide facilitates flexion?
Posterior
70
Q: What talocural joint PAM facilitates joint mobility and pain relief?
Distraction
71
Q: What talocural joint glide facilitates dorsiflexion?
Posterior or dorsal glide
72
Q: What talocural joint glide facilitates plantarflexion?
Anterior or ventral glide
73
Q: What subtalar joint PAM facilitates joint mobility and pain control?
Distraction
74
Q: What subtalar joint glide facilitates inversion?
Medial
75
Q: What subtalar joint glide facilitates eversion?
Lateral
76
Q: What glenohumeral joint glide facilitates ER, extension, horizontal ABD?
Anterior
77
Q: What glenohumeral joint glide facilitates IR, flexion, horizontal ADD?
Posterior
78
Q: What glenohumeral joint glide facilitates elevation?
Inferior
79
Q: What glenohumeral joint glide facilitates general hypomobility?
Lateral
80
Q: What scapular glide facilitates elevation?
Superior
81
Q: What scapular glide facilitates depression?
Inferior
82
Q: What scapular glide facilitates ABD/Protraction?
Lateral
83
Q: What scapular glide facilitates ADD/retraction?
Medial
84
Q: What humeroulnar PAM facilitates joint mobility?
Distraction
85
Q: What humeroulnar glide facilitates elbow extension?
Medial
86
Q: What humeroulnar glide facilitates elbow flexion?
Lateral
87
Q: What humeroradial PAM facilitates joint mobility?
Distraction
88
Q: What distal radioulnar glide facilitates pronation?
Volar
89
Q: What distal radioulnar glide facilitates supination?
Dorsal
90
Q: What distal wrist/hand glide facilitates wrist extension?
Volar
91
Q: What distal wrist/hand glide facilitates wrist flexion?
Dorsal
92
Q: What distal wrist/hand glide facilitates radial deviation?
Ulnar
93
Q: What distal wrist/hand glide facilitates ulnar deviation?
Radial
94
Q: What distal MCP glide facilitates flexion?
Volar
95
Q: What distal MCP glide facilitates extension?
Dorsal
96
Q: What distal MCP glide facilitates ABD?
Radial
97
Q: What distal MCP glide facilitates ADD?
Ulnar
98
Q: What distal MCP PAM facilitates joint mobility?
Traction
